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Sun L, Wang J, Yang Q, Guo Y. A comparative study on anti-MOG and anti-AQP4 associated optic neuritis following mild COVID-19: insights from a Chinese single-center experience. Front Neurol 2024; 15:1416493. [PMID: 38988608 PMCID: PMC11233519 DOI: 10.3389/fneur.2024.1416493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
Background Research on the relationship between mild COVID-19 and the subsequent development of isolated optic neuritis (ON) with antibodies specific to myelin oligodendrocyte glycoprotein (MOG-ON) and aquaporin 4 (AQP4-ON) is limited, particularly case-control studies that directly compare these conditions within the same affected population. Methods A retrospective analysis of initial MOG-ON and AQP4-ON cases during the COVID-19 peak and subsequent months. Patients were classified as possible COVID-19 related ON (PCRON) or non-COVID-19 related ON (NCRON). The study compared epidemiology, comorbidities, and clinical features between these groups. Results Patients with MOG-ON tended to develop ON symptoms closer in time to a mild COVID-19 infection compared to those with AQP4-ON (6.87 ± 6.25 weeks vs. 11.06 ± 5.84 weeks; p = 0.038), a significantly higher proportion of patients with MON-ON developing symptoms within 6 weeks after COVID-19 compared to those with AQP4-ON (15/23 [65.2%] vs. 5/17 [29.4%]; p = 0.025). Comparing MOG-ON and AQP4-ON patients, MOG-ON patients were more likely to have a recent infection before ON onset (73.1% vs. 30%; p = 0.007) and had better peak and post-treatment visual acuity (p = 0.01; p < 0.001). In contrast, AQP4-ON patients frequently showed comorbid connective tissue diseases (30.0% vs. 0%, p = 0.004) and antinuclear antibody abnormalities (40.0% vs. 7.7%, p = 0.012). Among MOG-ON patients, PCRON had increased rates of atherosclerotic vascular diseases (AVDs) (53.3% vs. 9.1%, p = 0.036), phospholipid antibody abnormalities (60.0% vs. 18.2%, p = 0.04), and bilateral visual impairment (66.7% vs. 9.1%, p = 0.005). Multivariate analysis pinpointed AVDs (OR = 15.21, p = 0.043) and bilateral involvement (OR = 25.15, p = 0.015) as independent factors related to COVID-19 associated MOG-ON, with both being good discriminators for PCRON (AUC = 0.879). No differences were found between the PCRON and NCRON groups in AQP4-ON patients. Conclusion Mild COVID-19 is more likely associated with MOG-ON than AQP4-ON. MOG-ON that develops within 6 weeks following a COVID-19 infection may be associated with the COVID-19 infection. AVDs may have a synergistic effect on MOG-ON in patients with COVID-19, which warrants further investigation. COVID-19 related MOG-ON often affects both eyes, and acute visual function damage can be severe, but generally has a good prognosis.
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Affiliation(s)
- Liang Sun
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qinglin Yang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanjun Guo
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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2
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Nakamura Y, Namba T, Kawazu Y, Yasui M. Pediatric acute disseminated encephalomyelitis following asymptomatic coronavirus disease 2019. IDCases 2024; 36:e01950. [PMID: 38699523 PMCID: PMC11063528 DOI: 10.1016/j.idcr.2024.e01950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/09/2024] [Accepted: 04/14/2024] [Indexed: 05/05/2024] Open
Abstract
After the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic emerged, the virus spread rapidly worldwide, and outbreaks continued to occur intermittently. Here, we present the case of a 5-year-old boy with acute disseminated encephalomyelitis (ADEM) and initial symptoms of dysphoria and pain in the right lower extremity. Around the time of this episode, the patient exhibited no fever or respiratory symptoms. Brain magnetic resonance imaging (MRI) revealed multiple T2-weighted image/fluid-attenuated inversion recovery high-signal areas bilaterally subcortical to the deep white matter, corpus callosum, and bilateral basal ganglia. MRI of the cervical and thoracic regions indicated a long lesion with continuous T2WI high signal intensity in the central gray matter. Serum aquaporin-4 antibody and serum myelin oligodendrocyte glycoprotein antibody tests were negative and positive, respectively. A polymerase chain reaction test using nasopharyngeal swab fluid upon admission was positive for SARS-CoV-2. Patients with severe coronavirus disease 2019 (COVID-19) in the acute phase may show central nervous system symptoms. There have been no previous reports of ADEM in the subacute phase of COVID-19, lacking symptoms in the acute phase, as in the present case. Notably, ADEM can develop in the subacute phase of asymptomatic COVID-19 infection.
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Affiliation(s)
- Yuta Nakamura
- Department of Pediatrics, Fukuyama City Hospital, Fukuyama, Japan
| | - Takahiro Namba
- Correspondence to: Department of Pediatrics, Fukuyama City Hospital, 5–23-1, Zaocho, Fukuyama, Hiroshima 721–8511, Japan.
| | - Yukiko Kawazu
- Department of Pediatrics, Fukuyama City Hospital, Fukuyama, Japan
| | - Masato Yasui
- Department of Pediatrics, Fukuyama City Hospital, Fukuyama, Japan
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3
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Schanda K, Mariotto S, Rudzki D, Bauer A, Dinoto A, Rossi P, Ferrari S, Jarius S, Wildemann B, Boso F, Giometto B, Engels D, Kümpfel T, Wendel EM, Rostasy K, Reindl M. Is there an immunological cross-reactivity of antibodies to the myelin oligodendrocyte glycoprotein and coronaviruses? Brain Commun 2024; 6:fcae106. [PMID: 38576796 PMCID: PMC10994262 DOI: 10.1093/braincomms/fcae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/08/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Recent reports indicated that myelin oligodendrocyte glycoprotein antibody-associated disease might be a rare complication after severe acute respiratory syndrome coronavirus 2 infection or vaccination. It is unclear whether this is an unspecific sequel of infection or vaccination or caused by possible immunological cross-reactivity of severe acute respiratory syndrome coronavirus 2 proteins and myelin oligodendrocyte glycoprotein. The aim of this study was therefore to elucidate whether there is an immunological cross-reactivity between severe acute respiratory syndrome coronavirus 2 spike or nucleocapsid proteins and myelin oligodendrocyte glycoprotein and to explore the relation of antibody responses against myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 and other coronaviruses. We analysed serum samples from patients with severe acute respiratory syndrome coronavirus 2 infection and neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 12) or without myelin oligodendrocyte glycoprotein-antibodies (n = 10); severe acute respiratory syndrome coronavirus 2 infection without neurological symptoms (n = 32); vaccinated patients with no history of severe acute respiratory syndrome coronavirus 2 infection and neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 10) or without myelin oligodendrocyte glycoprotein-antibodies (n = 9); and severe acute respiratory syndrome coronavirus 2 negative/naïve unvaccinated patients with neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 47) or without myelin oligodendrocyte glycoprotein-antibodies (n = 20). All samples were analysed for serum antibody responses to myelin oligodendrocyte glycoprotein, severe acute respiratory syndrome coronavirus 2, and other common coronaviruses (CoV-229E, CoV-HKU1, CoV-NL63 and CoV-OC43). Based on sample amount and antibody titres, 21 samples were selected for analysis of antibody cross-reactivity between myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 spike and nucleocapsid proteins using affinity purification and pre-absorption. Whereas we found no association of immunoglobulin G and A myelin oligodendrocyte glycoprotein antibodies with coronavirus antibodies, infections with severe acute respiratory syndrome coronavirus 2 correlated with an increased immunoglobulin M myelin oligodendrocyte glycoprotein antibody response. Purified antibodies showed no cross-reactivity between severe acute respiratory syndrome coronavirus 2 spike protein and myelin oligodendrocyte glycoprotein. However, one sample of a patient with myelin oligodendrocyte glycoprotein antibody-associated disease following severe acute respiratory syndrome coronavirus 2 infection showed a clear immunoglobulin G antibody cross-reactivity to severe acute respiratory syndrome coronavirus 2 nucleocapsid protein and myelin oligodendrocyte glycoprotein. This patient was also seropositive for other coronaviruses and showed immunological cross-reactivity of severe acute respiratory syndrome coronavirus 2 and CoV-229E nucleocapsid proteins. Overall, our results indicate that an immunoglobulin G antibody cross-reactivity between myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 proteins is rare. The presence of increased myelin oligodendrocyte glycoprotein-immunoglobulin M antibodies after severe acute respiratory syndrome coronavirus 2 infection may either be a consequence of a previous infection with other coronaviruses or arise as an unspecific sequel after viral infection. Furthermore, our data indicate that myelin oligodendrocyte glycoprotein-immunoglobulin A and particularly myelin oligodendrocyte glycoprotein-immunoglobulin M antibodies are a rather unspecific sequel of viral infections. Finally, our findings do not support a causative role of coronavirus infections for the presence of myelin oligodendrocyte glycoprotein-immunoglobulin G antibodies.
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Affiliation(s)
- Kathrin Schanda
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Dagmar Rudzki
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Angelika Bauer
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Alessandro Dinoto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Patrizia Rossi
- Neurology Unit, St Bassiano Hospital, Bassano del Grappa, 36100 Vicenza, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Federica Boso
- Neurology Unit, Trento Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, 38122 Trento, Italy
| | - Bruno Giometto
- Neurology Unit, Trento Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, 38122 Trento, Italy
| | - Daniel Engels
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, 81375 Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, 81375 Munich, Germany
| | - Eva-Maria Wendel
- Department of Neuropediatrics, Olgahospital/Klinikum Stuttgart, 70174 Stuttgart, Germany
| | - Kevin Rostasy
- Paediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, 45711 Datteln, Germany
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
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4
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Tan Z, Chia YMF, Mu X, Tan YJ. Inherited chromosomally-integrated human herpes virus 6 confounding test results in a patient with myelitis and optic neuritis - A case report. J Neuroimmunol 2024; 387:578283. [PMID: 38184892 DOI: 10.1016/j.jneuroim.2024.578283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 12/25/2023] [Accepted: 12/31/2023] [Indexed: 01/09/2024]
Abstract
A case of the 'perfect storm' of myelin oligodendrocyte glycoprotein (MOG) antibody-mediated myelitis, human herpesvirus 6 (HHV-6) reactivation, and COVID-19 infection was reported in 2021. This article reports a case of a similarly observed clinical triad, but with a different conclusion and explanation supported by laboratory test results and evidence from our literature review.
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Affiliation(s)
- Zhibin Tan
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore.
| | | | - Xiaomin Mu
- Department of Neurology, National Neuroscience Institute, Singapore
| | - You-Jiang Tan
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore
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Oertel FC, Hastermann M, Paul F. Delimiting MOGAD as a disease entity using translational imaging. Front Neurol 2023; 14:1216477. [PMID: 38333186 PMCID: PMC10851159 DOI: 10.3389/fneur.2023.1216477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/23/2023] [Indexed: 02/10/2024] Open
Abstract
The first formal consensus diagnostic criteria for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) were recently proposed. Yet, the distinction of MOGAD-defining characteristics from characteristics of its important differential diagnoses such as multiple sclerosis (MS) and aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorder (NMOSD) is still obstructed. In preclinical research, MOG antibody-based animal models were used for decades to derive knowledge about MS. In clinical research, people with MOGAD have been combined into cohorts with other diagnoses. Thus, it remains unclear to which extent the generated knowledge is specifically applicable to MOGAD. Translational research can contribute to identifying MOGAD characteristic features by establishing imaging methods and outcome parameters on proven pathophysiological grounds. This article reviews suitable animal models for translational MOGAD research and the current state and prospect of translational imaging in MOGAD.
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Affiliation(s)
- Frederike Cosima Oertel
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Hastermann
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
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6
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Himeno Y, Tateishi T, Irie KI, Ueno S, Morimitsu M, Mizoguchi S, Koga T, Taniwaki T. Association of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease with Coronavirus Disease 2019 Vaccination and Infection: A Case Report of Cortical Encephalitis and Transverse Myelitis Relapse. Intern Med 2023; 62:3549-3554. [PMID: 37743511 PMCID: PMC10749814 DOI: 10.2169/internalmedicine.2471-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
We herein report a case of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) that occurred following coronavirus disease 2019 (COVID-19) vaccination and its subsequent relapse after COVID-19 infection. A 34-year-old woman developed cortical encephalitis in the right temporoparietal lobe one week after receiving the mRNA-1273 vaccine. The cerebrospinal fluid was positive for anti-MOG antibody. Her symptoms gradually improved after three courses of intravenous methylprednisolone therapy. Six months later, she experienced a relapse of transverse myelitis following COVID-19 infection. Despite treatment with plasma exchange, the patient remained paralyzed in both lower limbs. We herein review the relationship between MOGAD and COVID-19 vaccination/infection.
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Affiliation(s)
- Yohei Himeno
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Takahisa Tateishi
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Ken-Ichi Irie
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Shuntaro Ueno
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Makoto Morimitsu
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Shino Mizoguchi
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Tamon Koga
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Takayuki Taniwaki
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
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7
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Zivelonghi C, Dinoto A, Irani SR, McKeon A, Pilotto A, Padovani A, Masciocchi S, Magni E, Mancinelli CR, Capra R, Maniscalco GT, Volonghi I, Easton A, Alberti D, Zanusso G, Monaco S, Salvagno GL, Lippi G, Ferrari S, Mariotto S. SARS-CoV-2 antibodies in inflammatory neurological conditions: a multicentre retrospective comparative study. Immunol Res 2023; 71:717-724. [PMID: 37171542 PMCID: PMC10177711 DOI: 10.1007/s12026-023-09384-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/18/2023] [Indexed: 05/13/2023]
Abstract
It is well established that neurological and non-neurological autoimmune disorders can be triggered by viral infections. It remains unclear whether SARS-CoV-2 infection induces similar conditions and whether they show a distinctive phenotype. We retrospectively identified patients with acute inflammatory CNS conditions referred to our laboratory for antibody testing during the pandemic (March 1 to August 31, 2020). We screened SARS-COV-2 IgA/IgG in all sera by ELISA and confirmed the positivity with additional assays. Clinical and paraclinical data of SARS-COV-2-IgG seropositive patients were compared to those of seronegative cases matched for clinical phenotype, geographical zone, and timeframe. SARS-CoV-2-IgG positivity was detected in 16/339 (4%) sera, with paired CSF positivity in 3/16. 5 of these patients had atypical demyelinating disorders and 11 autoimmune encephalitis syndromes. 9/16 patients had a previous history of SARS-CoV-2 infection and 6 of them were symptomatic. In comparison with 32 consecutive seronegative controls, SARS-CoV-2-IgG-positive patients were older, frequently presented with encephalopathy, had lower rates of CSF pleocytosis and other neurological autoantibodies, and were less likely to receive immunotherapy. When SARS-CoV-2 seropositive versus seronegative cases with demyelinating disorders were compared no differences were seen. Whereas seropositive encephalitis patients less commonly showed increased CSF cells and protein, our data suggest that an antecedent symptomatic or asymptomatic SARS-CoV-2 infection can be detected in patients with autoimmune neurological conditions. These cases are rare, usually do not have specific neuroglial antibodies.
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Affiliation(s)
- Cecilia Zivelonghi
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Alessandro Dinoto
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy.
| | - Sarosh R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
- Oxford Epilepsy Research Group, University of Oxford, Oxford, UK
| | - Andrew McKeon
- Department of Laboratory Medicine and Pathology, Rochester, MN, USA
- Department of Neurology Mayo Clinic, Rochester, MN, USA
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Stefano Masciocchi
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Eugenio Magni
- Neurology Unit, Poliambulanza Hospital, Brescia, Brescia, Italy
| | - Chiara R Mancinelli
- Multiple Sclerosis Center, ASST - Spedali Civili of Brescia, Brescia, Montichiari, Italy
| | - Ruggero Capra
- Multiple Sclerosis Center, ASST - Spedali Civili of Brescia, Brescia, Montichiari, Italy
| | - Giorgia T Maniscalco
- Multiple Sclerosis Center "A. Cardarelli" Hospital, Naples, Italy
- Neurological Clinic and Stroke Unit "A. Cardarelli" Hospital, Naples, Italy
| | - Irene Volonghi
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Ava Easton
- Encephalitis Society, 32 Castlegate, Malton, UK
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool , Liverpool, England
| | - Daniela Alberti
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Gianluigi Zanusso
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Salvatore Monaco
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Gian Luca Salvagno
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
- Service of Laboratory Medicine, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Sara Mariotto
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy.
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8
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Shi M, Luo D, Li Z, Li M, Jin S, Yang D, Guo J, Chen G. A case report of neurosyphilis coexisting with a positive MOG antibody manifested as optic neuritis. Front Neurol 2023; 14:1258043. [PMID: 37859651 PMCID: PMC10583717 DOI: 10.3389/fneur.2023.1258043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/19/2023] [Indexed: 10/21/2023] Open
Abstract
Background Neurosyphilis refers to an infection of the central nervous system by Treponema pallidum. The clinical manifestations of neurosyphilis are diverse, making it easy to miss or misdiagnose. Anti-myelin oligodendrocyte glycoprotein antibody-associated disease is a recently defined immune-mediated inflammatory demyelinating central nervous system disease. Few studies have reported the coexistence of the two diseases. Case presentation This case report presents a 37 years-old male patient with neurosyphilis manifested as optic neuritis with a positive myelin oligodendrocyte glycoprotein (MOG) antibody. This patient received intravenous administration of 3.2 million units of procaine penicillin every 4 h for 2 weeks, followed by a two-week intramuscular injection of benzathine penicillin. Additionally, methylprednisolone sodium succinate was administered intravenously at 1,000 mg/day, gradually reduced to 500 mg/day and 240 mg/day every 3 days. Subsequently, prednisone tablets at a dosage of 60 mg/day were orally administered, with a gradual reduction of 5 mg/day every 3 days until reaching a dosage of 30 mg/day. The patient's visual acuity was improved after 26 days of hospitalization. However, the visual field and color vision did not. At 3 months of follow-up, the symptoms remained unchanged despite the patient continued taking oral prednisone tablets at a dosage of 30 mg/day. Conclusion Neurosyphilis could be a potential triggering factor for MOGAD. In patients with neurosyphilis, it is strongly recommended to perform testing for MOG antibody along with other brain disease antibodies.
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Affiliation(s)
- Min Shi
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Danqing Luo
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhaoying Li
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Man Li
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuoguo Jin
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongdong Yang
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Guo
- Department of Neurology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Guo Chen
- Department of Infectious Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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9
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Gilardi M, Cortese A, Ferraro E, Rispoli M, Sadun R, Altavista MC, Sadun F. MOG-IgG positive optic neuritis after SARS-CoV-2 infection. Eur J Ophthalmol 2023; 33:NP87-NP90. [PMID: 36317310 PMCID: PMC9623410 DOI: 10.1177/11206721221136319] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Many neurologic complications have been described after severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) including atypical cases of optic neuritis (ON), positive to myelin oligodendrocyte glycoprotein (MOG) IgG. OBJECTIVE To report a case of MOG-IgG-associated ON and discuss why SARS-CoV-2 infection could be a potential trigger. METHODS Retrospective single case report. RESULTS We report a case of ON with positive MOG-IgG developed 15 days after presentation of SARS-CoV-2 infection. CONCLUSION This report suggests that SARS-CoV-2 infection may have triggered autoantibodies production against MOG leading to ON.
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Affiliation(s)
- Marta Gilardi
- Neuro-Ophthalmology Unit, Presidio Ospedaliero
Oftalmico, Rome, Italy
| | - Antonio Cortese
- Multiple Sclerosis Centre, Presidio Ospedaliero San Filippo
Neri, Rome, Italy
| | - Elisabetta Ferraro
- Multiple Sclerosis Centre, Presidio Ospedaliero San Filippo
Neri, Rome, Italy
| | - Marco Rispoli
- Neuro-Ophthalmology Unit, Presidio Ospedaliero
Oftalmico, Rome, Italy
| | - Riccardo Sadun
- Università Cattolica del Sacro Cuore
School of Medicine, Rome, Italy
| | | | - Federico Sadun
- Neuro-Ophthalmology Unit, Presidio Ospedaliero
Oftalmico, Rome, Italy
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Borończyk M, Węgrzynek J, Borończyk A, Siuda J. The MOG antibody associated encephalitis preceded by COVID-19 infection; a case study and systematic review of the literature. Front Neurol 2023; 14:1239657. [PMID: 37638199 PMCID: PMC10449573 DOI: 10.3389/fneur.2023.1239657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Background New neurological complications of COVID-19 infection have been reported in recent research. Among them, the spectrum of anti-MOG positive diseases, defined as anti-MOG antibody associated disease (MOGAD), is distinguished, which can manifest as optic neuritis, myelitis, or various forms of encephalitis (MOGAE). Materials and methods This study reports a new case of MOGAE following SARS-CoV-2 infection. A literature review of other MOGAE cases associated with COVID-19 infection was conducted and summarized. Results A 60-year-old male patient, who had previously been infected with COVID-19, was admitted to the Neurology Department with a rapidly progressive deterioration of his cognitive functions that lasted for about 3 months. On neurological examination, the Mini-Mental State Examination (MMSE) score was 17, which further deteriorated to 13. In addition, central paresis of the right VIIth nerve and pyramidal hemiparesis on the right side were noted. The MRI of the brain showed multiple hyperintense lesions. The CSF examination revealed an elevated total protein level with a normal cell count, and serum showed a positive finding of anti-MOG antibodies. Taking into account all the information, the diagnosis of MOGAE, following COVID-19 infection, was made. A total of 9 similar cases of MOGAE associated with SARS-CoV-2 infection were identified in the available literature. Among them 2 cases presented progressive cognitive dysfunction and another 5 altered mental status. The most frequently described MRI changes were hyperintense lesions located cortically and/or subcortically. Anti-MOG antibodies were positive in all patients. In 5 cases they were detected only in serum, in 2 cases in serum and CSF, and in 2 cases the origin was not reported. Conclusion The reported cases of MOGAE following COVID-19 infection suggest an increasing new clinical problem, and show an association between COVID-19 and MOGADs.
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Affiliation(s)
- Michał Borończyk
- Students' Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Julia Węgrzynek
- Students' Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Borończyk
- Students' Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Siuda
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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11
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Dinkin M, Sathi S. Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19. Semin Neurol 2023. [PMID: 37311536 DOI: 10.1055/s-0043-1767715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.
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Affiliation(s)
- Marc Dinkin
- Department of Ophthalmology, Weill Cornell Medical College, NY Presbyterian Hospital, New York, New York
- Department of Neurology, Weill Cornell Medical College, NY Presbyterian Hospital, New York, New York
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12
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Lee Y, Ahn SJ, Lee HS, Kim Y, Lee S, Park H, Moon J, Lee SK, Chu K. Myelin oligodendrocyte glycoprotein antibody-associated encephalitis after severe acute respiratory syndrome coronavirus 2 infection: a case report and retrospective case reviews. ENCEPHALITIS 2023; 3:71-77. [PMID: 37469677 PMCID: PMC10295827 DOI: 10.47936/encephalitis.2022.00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 07/21/2023] Open
Abstract
Several cases of myelin oligodendrocyte glycoprotein (MOG) antibody-associated encephalitis have been reported after coronavirus disease 2019 (COVID-19). In this case, the patient presented with focal status epilepticus with impaired awareness, auditory hallucinations, and incoherent speech after COVID-19. Brain magnetic resonance imaging revealed no specific findings. Cerebrospinal fluid results showed pleocytosis and MOG antibody testing confirmed anti-MOG antibody with live cell-based fluorescence-activated cell sorting assay. The patient was diagnosed with MOG antibody-associated autoimmune encephalitis and treated with intravenous immunoglobulin, rituximab, and tocilizumab. This case occurred presumably due to auto-antibody production following COVID-19.
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Affiliation(s)
- Yoonkyung Lee
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seon-Jae Ahn
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - Han-Sang Lee
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - Yongmoo Kim
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seolah Lee
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeyoung Park
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - Jangsup Moon
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Genomic Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Kun Lee
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kon Chu
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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13
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Cautilli F, Feleppa M, Valeriani M, Papetti L, Monte G, Midulla F, Spalice A. Case report: A case of acute disseminated encephalomyelitis after SARS-CoV-2 infection in pediatric patients. Front Neurol 2023; 14:1099458. [PMID: 36908623 PMCID: PMC9992531 DOI: 10.3389/fneur.2023.1099458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/19/2023] [Indexed: 02/24/2023] Open
Abstract
Introduction Since the beginning, there has been enough evidence about the multi-systematic involvement of the coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent observations have revealed that, together with others, typical neurological manifestations are also associated with COVID-19 infection. In the first 2 years, children accounted for a few percent of cases, but with the emergence of the Omicron variant, the number of cases in the pediatric population has increased. It has been described that ~5% of the affected population suffered from severe neurological complications, such as seizure, coma, encephalitis, demyelinating disorders, and aseptic meningitis. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system. Typically, it presents in childhood and occurs 1 or 2 weeks after infection or vaccination. Case presentation We present the case of a 12-year-old boy who developed ADEM, 10 days after an asymptomatic SARS-CoV-2 infection. Neurological symptoms began with headache, fever, irritability, paraplegia, and loss of sensitivity from the T1 level. The diagnosis of ADEM was confirmed by the typical signs found on brain MRI, whereas spinal cord MRI showed signs of transverse myelitis. The cerebrospinal fluid (CSF) testing excluded infections and did not reveal oligoclonal antibody bands (anti-MOG-negative and anti-AQP-negative). High-dose steroids (30 mg/kg/day) and IVIG (2 g/kg) were administered to the patient without any clinical improvement. The patient received a cycle of plasma exchange therapy, followed by rituximab infusion, with partial improvement. After 3 months, the magnetic resonance imaging (MRI) results demonstrated radiological improvement in accordance with the ADEM diagnosis. Conclusion This clinical case confirms that SARS-CoV-2 infections are increasingly implicated in severe neurological consequences in both adult and pediatric patients. While the most frequent complications that were reported in children included headache, altered mental status, and encephalopathy, ~5% of the individuals suffered from severe neurological complications, leading to lifelong sequelae. All physicians must be aware of these data and detect neurological signs of severe (or not) complications that require a specific follow-up and treatment.
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Affiliation(s)
- Francesca Cautilli
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Mariavittoria Feleppa
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | | | - Laura Papetti
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gabriele Monte
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabio Midulla
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Alberto Spalice
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
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14
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Adamec I, Brecl Jakob G, Drulović J, Sellner J, Bilić E, Sitaš B, Bilić H, Tamaš O, Budimkić M, Veselinović N, Horvat Ledinek A, Jerše J, Gomezelj S, Hauer L, Krbot Skorić M, Habek M. Transverse myelitis following COVID-19: Insights from a multi-center study and systematic literature review. J Neurol Sci 2022; 443:120463. [PMID: 36334503 DOI: 10.1016/j.jns.2022.120463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/03/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We aimed to provide insights into transverse myelitis (TM) following COVID-19 by analyzing cases treated at tertiary care neurology centers and a systemic review of the literature. METHODS The retrospective observational multi-center study was conducted at the four university neurology departments in Croatia, Slovenia, Serbia, and Austria. We searched for acute myelitis cases that occurred during or after COVID-19. A systemic review of the literature on COVID-19 and transverse myelitis was performed. RESULTS We identified 76 persons with TM associated with COVID-19, 13 from the multi-center study and 63 from the literature review. Most of the participants (55.6%) had an intermediate latency, 25.4% had short and 19% long latency from COVID-19 symptoms to TM. The clinical presentation consisted of the typical TM signs. More than half of the participants had inflammatory changes in the CSF, with rare patients having intrathecal OCB synthesis and positive serology for anti-MOG or anti-AQP4 antibodies. Persons with autonomic symptoms and CSF pleocytosis were significantly more common to have an intermediate latency of 8 to 21 days from COVID-19 to TM (p = 0.005 and p = 0.003; respectively). According to logistic regression analysis, only participants with lesions evident on spinal cord MRI compared to normal spinal cord MRI had reduced risks for poor recovery. >80% of participants were treated with a combination of corticosteroids and intravenous immunoglobulins or plasma exchange with 73% having incomplete recovery. CONCLUSION Our study further characterizes clinical, laboratory, and MRI features, as well as treatment of TM associated with COVID-19.
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Affiliation(s)
- Ivan Adamec
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Gregor Brecl Jakob
- University Medical Centre Ljubljana, Department of Neurology, Ljubljana, Slovenia.
| | - Jelena Drulović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; University Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia.
| | - Johann Sellner
- Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
| | - Ervina Bilić
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Barbara Sitaš
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
| | - Hrvoje Bilić
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
| | - Olivera Tamaš
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; University Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia.
| | - Maja Budimkić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; University Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia.
| | - Nikola Veselinović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; University Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia.
| | | | - Jana Jerše
- University Medical Centre Ljubljana, Department of Neurology, Ljubljana, Slovenia.
| | - Sarah Gomezelj
- University Medical Centre Ljubljana, Department of Neurology, Ljubljana, Slovenia.
| | - Larissa Hauer
- Christian Doppler Medical Center, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Paracelsus Medical University, Salzburg, Austria.
| | - Magdalena Krbot Skorić
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia.
| | - Mario Habek
- University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
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15
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Li L, Li C, Yao D, Hao YF, Zhao C, Yan Q, Liu JT, Liu SY, Zhu WP, Du Y, Zhang W. Case report: MOG-IgG-associated encephalitis with Epstein-Barr virus infection and Alzheimer's pathologic change in cerebrospinal fluid. Front Neurol 2022; 13:1013413. [PMID: 36530610 PMCID: PMC9755887 DOI: 10.3389/fneur.2022.1013413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/10/2022] [Indexed: 09/30/2023] Open
Abstract
Immunoglobulin G antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) associated disease is a rare, demyelinated disease in the central nerve system (CNS) predominately involving optic nerve, spinal cord, and brain leading to optic neuritis (ON), transverse myelitis (TM), encephalitis. The phenotype of MOG-IgG-associated encephalitis is similar to acute disseminated encephalomyelitis (ADEM) presenting with seizures, abnormal behavioral and psychological symptoms, and cognitive impairment. A few brain biopsies show multiple sclerosis (MS) pattern histopathology with T cells, macrophages, and complement activation. To date, how MOG-IgG is produced is unknown. Herein, we report a case of a 32-year-old male with MOG-IgG-associated encephalitis presenting MOG-IgG in cerebrospinal fluid (CSF) but seronegative, as well as Epstein-Barr virus (EBV) infection and Alzheimer's pathologic change in CSF (Aβ42 = 317 pg/ml, T-Tau = 538 pg/ml, p-Tau =10.09 pg/ml). With a combination treatment of administering intravenous immunoglobulin (0.4 mg/kg/d, 5 days) with a low dose of methylprednisolone (80 mg/d, 5 days) and rituximab (100 mg/week, 3 weeks), the patient recovered significantly after 3 months follow-up. This case provides us with new thoughts into the production of MOG-IgG and the possible pathologic mechanism of MOG-IgG-associated disease (MOG-AD) and simultaneously further confirms the interaction between EBV and changes of CSF biomarkers of Alzheimer's disease (AD).
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Affiliation(s)
- Lin Li
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Chuan Li
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Dan Yao
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yun-feng Hao
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Chao Zhao
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Qi Yan
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Jun-tong Liu
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Xi'an Medical University, Xi'an, China
| | - Shu-yu Liu
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Xi'an Medical University, Xi'an, China
| | - Wen-ping Zhu
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Xi'an Medical University, Xi'an, China
| | - Ying Du
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Zhang
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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16
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Author's response to the commentary: Neuromyelitis optica complicating COVID vaccinations and additional case reports. Mult Scler Relat Disord 2022; 66:104055. [PMID: 35843141 PMCID: PMC9273309 DOI: 10.1016/j.msard.2022.104055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 11/20/2022]
Abstract
Our article Newly diagnosed neuromyelitis optica spectrum disorders following vaccination: Case report and systematic review had instigated a critique that there were more cases of post-COVID-19-vaccination NMOSD. Indeed, after the systematic review was performed in July 2021, many reports have been published, and we have seen two new patients at our center as well. However, Finsterer's question on the subclinical activity of NMOSD prior to vaccination, although an interesting notion, was debatable. NMOSD is a relapsing disease with severe attacks. Investigations in our patients did not reveal robust evidence of prior subclinical attacks so far.
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17
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Johnsson M, Asztely F, Hejnebo S, Axelsson M, Malmeström C, Olausson T, Lycke J. SARS-COV-2 a trigger of myelin oligodendrocyte glycoprotein-associated disorder. Ann Clin Transl Neurol 2022; 9:1296-1301. [PMID: 35713508 PMCID: PMC9349599 DOI: 10.1002/acn3.51609] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/15/2022] Open
Abstract
SARS-COV-2 frequently cause neurological disorders and is sometimes associated with onset of autoimmune diseases affecting the nervous system. Over recent years, a rare but distinct diagnosis designated myelin oligodendrocyte glycoprotein-associated disorder (MOGAD) has been recognized in patients with attacks of optic neuritis, myelitis, or encephalomyelitis and increased levels of anti-MOG antibodies. The cause of MOGAD is unknown. However, there have been reports of single cases of MOGAD in patients with Covid-19 infection. We report a series of SARS-CoV-2 positive patients that developed MOGAD, but a homology search did not support a cross-reactive immune response to SARS-CoV-2 spike-protein and MOG.
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Affiliation(s)
- Magnus Johnsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fredrik Asztely
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Markus Axelsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Clas Malmeström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Torbjörn Olausson
- Department of Clinical Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Lycke
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
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18
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Tanasescu R, Reindl M. Guilty by association? SARS-Cov2 antibodies and MOGAD. Eur J Neurol 2022; 29:1569-1570. [PMID: 35332636 PMCID: PMC9111699 DOI: 10.1111/ene.15335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Radu Tanasescu
- Academic Clinical Neurology, Division of Clinical Neuroscience, University of Nottingham, UK.,Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
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